Provider Demographics
NPI:1780755447
Name:OBRIEN, DEBRA (MD)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WHITE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4039
Mailing Address - Country:US
Mailing Address - Phone:732-741-3400
Mailing Address - Fax:732-741-3104
Practice Address - Street 1:20 WHITE RD
Practice Address - Street 2:SUITE D
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4039
Practice Address - Country:US
Practice Address - Phone:732-741-3400
Practice Address - Fax:732-741-3104
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69550174400000X
NJ25MA06955000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist